Individual
MARY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
1622 SILVER ST, JACKSONVILLE, FL 32206-4446
(904) 356-3022
(904) 350-9165
Mailing address
1622 SILVER ST, JACKSONVILLE, FL 32206-4446
(904) 356-3022
(904) 356-3022
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
8638
FL
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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